Tertiary peptide bond containing-oligo(Leu)s

In order to elucidate the role of tertiary peptide bonds in the conformational development and solubility improvement of peptides, the conformational properties of oligo(Leu)s with the Pro residue and the Gly-(Dmob)Leu sequence were investigated in solution using i.r. absorption, CD, and molar rotation measurements. The i.r. absorption spectroscopy indicated that the peptides soluble in inert solvents such as CCl₄ and toluene had a predominantly β-sheet structure in these solvents. The conformations of the peptides in CCl₄ and toluene were essentially the same as those in a solid state, whereas in THF and in MeOH, the peptides examined were efficiently subjected to solvation, and a randomly coiled structure was predominant. In order to confirm the randomly coiled structure, measurements have been made of the molar rotations of the peptides in a variety of strong proton acceptor and donor solvents. CD measurements are also carried out in MeOH. Through the investigations, it was shown that the protection of peptide bonds and the insertion of the Pro residue had the same effect on conformational and solubilizing behaviors and induced onset of an unordered structure and easy solvation of the peptides in medium and high polarity-solvents.     

Aclarubicin in the Treatment of Multiple Myeloma

Fourteen patients with multiple myeloma received aclarubicin(ACR) intravenous drip infusion at a dose of 15–25 mg/m²/dayfor 7 days every 3 weeks. Nine of the patients achieved more than a 25% reduction in M-protein.In two of the nine the reduction was more than 50% and the durationof their responses was 2.0 and 2.8 months, respectively. Inthe nine cases of previous combination chemotherapy-resistantmultiple myeloma, five showed more than a 25% reduction andone of them showed more than a 50% reduction in M-protein. Oneof the two patients with tumors achieved a marked regressionof the tumor mass and two of the 14 patients showed marked improvementin subjective symptoms. Hematological toxicity, anorexia, nausea and vomiting occurredfrequently. However, no cardiac toxicity obviously attributableto ACR was detected, and alopecia was generally mild. Thus,the above results indicate that ACR may be useful in combinationchemotherapy for multiple myeloma because of its effectivenessand relatively low dose-limiting factors.     

Acceleration of wound contraction and healing with a photocrosslinkable chitosan hydrogel

Application of ultraviolet light irradiation to a photocrosslinkable chitosan aqueous solution resulted in an insoluble, flexible hydrogel like soft rubber within 60 seconds. In order to evaluate its accelerating effect on wound healing, full-thickness skin incisions were made on the backs of mice and subsequently a photocrosslinkable chitosan aqueous solution was added into the wound and irradiated with UV light for 90 seconds. Application of the chitosan hydrogel significantly induced wound contraction and accelerated wound closure and healing compared with the untreated controls. Histological examination also showed an advanced contraction rate on the first 2 days and tissue fill rate on days 2 to 4 in the chitosan hydrogel-treated wounds. Furthermore, in cell culture studies, chitosan hydrogel culture medium supplemented with 5% fetal-bovine serum was found to be chemoattractant for human dermal fibroblasts in an invasion chamber assay using filters coated with Matrigel and in a cell migration assay. Due to its ability to accelerate wound contraction and healing, chitosan hydrogel may become accepted as an occlusive dressing for wound management.     

Analysis of urgent colonoscopy for acute lower intestinal bleeding

Background: Urgent colonoscopy is often performed to diagnose and stop acute lower intestinal bleeding, but its usefulness has yet to be clarified. The aim of this study was to clarify the present role of urgent colonoscopy for this purpose. Methods Urgent colonoscopy was defined as colonoscopy performed within 48 h of the occurrence of hematochezia. All patients investigated by urgent colonoscopy from September 1996 to March 2000 who were hospitalized in Shimane Medical University Hospital or Shimane Prefectural Central Hospital, Japan, were enrolled in this study. The endoscopic data and medical records of all the investigated patients were reviewed retrospectively to clarify the role of urgent colonoscopy for diagnosing and treating patients with hematochezia. Results A total of 152 patients were enrolled and 137 (90.1%) were successfully diagnosed endoscopically. Ischemic colitis was the most frequent disease found (32.9%), followed by postpolypectomy hemorrhage (9.2%), hemorrhoids (8.6%) and rectal ulcer (7.2%). Endoscopic hemostasis was employed to treat postpolypectomy hemorrhage and bleeding rectal ulcers with favorable results. Conclusions Urgent colonoscopy is useful for the diagnosis of hematochezia. Endoscopic hemostasis is frequently required to treat postpolypectomy hemorrhage and bleeding rectal ulcers.     

Experience and functional outcome of modified ileal neobladder in 95 patients

AIMS: We took advantage of the Goodwin method to develop a modified ileal neobladder. We present the operation procedure and assessed the functional results. METHODS: From April 1997 and May 2005, 95 patients (75 men and 20 women), mean age 64.6 years (range: 36-80 years) underwent orthotopic ileal neobladder replacement with application of the Goodwin method. The Le Duc technique was used for antireflux procedure. However, for the last 35 patients, antireflux procedure was not carried out. The median follow-up period was 37 months (range: 3-98 months). We reviewed the surgical outcome and complications. Continent status and urodynamic profile were also measured. RESULTS: The mean operation time for the neobladder formation was 130 mins (range: 65-285 mins). There were no perioperative deaths. Leakage from the ileourethral anastomosis leak was found in four patients (4.2%), wound infection in nine patients (9.5%), ileal anastomosis leak in two patients (2.1%) and paralytic ileus in two patients. No hydronephrosis, neobladder-ureteral reflux or deterioration of renal function was seen. The maximum neobladder pressure was 21 +/- 13 cm (mean +/- SD) at 6 months and 12 +/- 11 cm at 12 months after surgery. The neobladder capacity was 293 +/- 118 mL at 6 months and 312 +/- 85 mL at 12 months after surgery. Of the 95 patients, 87 (91.6%) maintained complete dryness day and night. CONCLUSIONS: These results suggest that the present orthotopic ileal neobladder is simple to be carried out and achieves acceptable voiding function. Longer observation for neobladder and upper urinary tract function is necessary.     

Complications of percutaneous transhepatic catheterization of the portal venous system in patients with portal hypertension

We report here complications of percutaneous transhepatic catheterization of the portal venous system in 170 Japanese patients with portal hypertension. All patients underwent percutaneous transhepatic portography and percutaneous transhepatic obliteration of oesophagogastric varices was also performed in 29 patients. After retraction of the catheter, the puncture canal was plugged with gelatin sponge in 150 subjects and with one steel coil in 20 others. The overall complication rate was 16.5%. Intraperitoneal bleeding occurred in 10.6% of patients and 2.9% required blood transfusion. In these patients with intraperitoneal bleeding, the gelatin sponge was used for plugging after retraction of the catheter, while in the 20 patients with a steel coil plug, haemoperitoneum never occurred. Right pleural effusion was recognized in 3.5% of patients, intraperitoneal bile leakage in 1.8% and deterioration of liver function due to arteriovenous fistula in 0.6%. By univariate and multivariate analyses, female gender was the only risk factor for intraperitoneal bleeding among 150 patients investigated by percutaneous transhepatic catheterization of the portal venous system with gelatin sponge plugging. Intraperitoneal bleeding is the most important complication in patients with portal hypertension; it is difficult to predict intraperitoneal bleeding before retraction of the catheter in patients for whom gelatin sponge is used. Thus, for patients undergoing percutaneous transhepatic catheterization of the portal venous system, close follow up is recommended.     

Deep venous thrombosis of the leg due to psychiatric stupor

Abstract  We report the cases of two patients with psychiatric stupor who developed venous thrombosis. A 29-year-old schizophrenic woman had been hospitalized in psychiatric institutions three times because of stupor associated with auditory hallucinations and thought blocking. These symptoms recurred and she was admitted to our hospital with deep venous thrombosis of her left leg. The other patient was a 67-year-old woman with depression. She had also suffered from insomnia. Following admission to our hospital, she developed a depressive stupor complicated by deep venous thrombosis of her left leg. Both cases were treated with sodium heparin and urokinase, and completely resolved. It is well known that dehydration, infection and decubitus ulcers are important physical complications of psychiatric stupor, but there have been few reports of deep venous thrombosis as a physical complication of stupor.     

Slow Potential-Guided Radiofrequency Catheter Ablation in Atrioventricular Nodal Reentrant Tachycardia: Characteristics of the Potential Associated with Successful Ablation

To examine the characteristics of Haïssaguerre's slow potential (SP) specific to effective catheter ablation of the slow pathway in AV nodal reentrant tachycardia, the properties of SP and its recording site ware analyzed in 52 patients who underwent successful SP-guided ablation. The properties of SP included the ratio of the amplitude of SP to that of atrial potential (A)(SP/A), the SP duration, the interval between His-bundle potential (HP) and SP (HP-SP), the interval between A and SP (A-SP), the interval between SP and ventricular potential (V) (SP-V), and the ratio of A-SP to the interval between A and the V (A-SP/A-V). The SP recording site was determined by the ratio of the amplitude of A to that of V (A/V) and by the relative position of the ablation catheter on X ray (right anterior oblique projection), expressed as the ratio of the distance between the coronary sinus ostium and SP site to that between the coronary sinus ostium and HP recording site (relative SP position). Twenty-eight slow pathways were ablated with a single energy application, while the other 24 required applications ≥ 2. In all successful applications, SP/A, SP duration, HP-SP, A-SP. SP-V, A-SP/A-V, A/V, and relative SP position were 51 %± 25%, 28 ± 5 ms, -11 ± 9 ms, 57 ± 25 ms, 68 ± 13 ms, 46%± 9%, 15%± 13%, and 51%± 13%, respectively. A significant correlation was observed between the relative SP position and A-SP, and between the relative SP position and A-SP/A-V (r = 0.60 and 0.37, respectively), while it was not between the relative SP position and HP-SP, nor between the relative SP position and SP-V. When the characteristics of SP were comparatively analyzed between the effective and ineffective applications in 24 patients in whom applications ≥ 2 were required, there was no difference observed in HP-SP, A-SP, SP-V, A-SP/A-V, and A/V. However, SP/A, SP duration, and the relative SP position in the effective applications were all greater than those in the ineffective ones (56%± 20% vs 35%± 18%, P < 0.001; 29 ± 4 vs 26 ± 5 ms, P < 0.01; and 52%± 15% vs 33%± 11%, P < 0.001, respectively). These results indicate that SP with an amplitude over a half of A amplitude and recorded at the mid-septum of the tricuspid annulus can be a marker for successful slow pathway ablation. Although the local atrial electrogram appears late as the SP recording site shifts to the lower position, the timing of SP relative to HP and V remained unchanged, suggesting that SP is independent of the local atrial activation.     

Idiopathic Reentrant Right Ventricular Outflow Tract Tachycardia With Presystolic Potential of Central Pathway

Idiopathic Reentrant RVOT VT With Presystolic Potential . A 12‐year‐old girl with recurrent palpitation due to idiopathic ventricular tachycardia (VT) with a left bundle branch block configuration and inferior axis was referred to our hospital. During the VT, a spiky presystolic potential (SP) was recorded at the septum of right ventricular outflow tract (RVOT) just below pulmonary valve. The SP was entrained with a decremental property by pacing from right ventricular apex. Concealed entrainment was observed by pacing where the SP was recorded. Delivery of radiofrequency current targeting the SP abolished the VT. The SP with the decremental property could represent the central pathway of this idiopathic RVOT reentrant VT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1174‐1177)